Organization
SOAR PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BURTON WILLIAM STEVENS JR. PT, DPT, SCS, ATC (PHYSICAL THERAPIST/ OWNER)
(770) 704-8244
Entity
Organization
Contact information
Practice address
6884 HICKORY FLAT HWY, WOODSTOCK, GA 30188-3229
(770) 704-8244
(770) 704-8264
Mailing address
6884 HICKORY FLAT HWY, WOODSTOCK, GA 30188-3229
(770) 704-8244
(770) 704-8264
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT009114
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511G701183
MEDICARE PTAN
GA
Enumeration date
08/25/2008
Last updated
03/23/2016
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